Beyond Strength Roadmap Questionnaire

1-on-1 Assessment & Goal-Setting Questionnaire

Today's Date *

Name *

Age

Occupation *

I'd like for you to imagine that we're sitting down 12 months from now, and in the past 12 months you committed to not just join Beyond Strength, but that you took the time to set goals that excite you, showed up with consistency in all the right ways, and you took serious action to make those goals a reality... Looking back on all you've accomplished, what will you be most proud of? *

Why is that important to you? *

What have you already tried to accomplish your goals? And why do you think these things didn't work? Or, if they did, why didn't you stick with them? *

What do you see as the absolute biggest hurdle you face in order to accomplish your goals? What will it take for you to overcome that? *

Are you currently training somewhere (even if that's consistently training at home OR doing a trial at another gym as well)?

Yes (please tell us where and how many times per week if you click this option)Yes (please tell us where and how many times per week if you click this option)

How many days per week are you realistically able AND willing to train at Beyond Strength?

Do you see yourself training in the morning, midday, or afternoons/evenings?

Do you know how many steps you average per day?

Do you know how much water you drink, on average, per day?

What are your top 3 nutrition stumbling blocks?

On average, how many hours of sleep do you get each night? *

Do you smoke? *

Yes

How many alcoholic beverages do you consume per week?

How full is your cup? *

When things get stressful, how do you tend to respond? What are your outlets? *

Please list any current AND past injuries and surgeries. We don't need to know about routine procedures like wisdom teeth, tonsils, ... but if you've been injured and/or had surgery that was due to a complication or event that impacted your ability to take part in your daily activities of living, please list them out below with a general timeframe (i.e., month and/or year). *

Are you taking any medications that have contraindications for exercise? *

Yes

If yes to medications, please list:

Are you aware of anything that we haven't already covered that would impact our ability to put you in the best position to be successful? *

YesYes

If you are human, leave this field blank.